Manual release for medical device drive system

ABSTRACT

A medical device drive system can include a rotational input, a coupling member engaged with the rotational input, a first gear having an engagement feature sized and shaped to engage with the coupling member, and a second gear coupled with the first gear, the second gear coupled to a movable element. The system can have a first system state and a second system state. In the first system state the coupling member is not engaged with the engagement feature and the first gear rotates without moving the coupling member. In the second system state the coupling member is engaged with the engagement feature of the first gear and rotation of the rotational input turns the coupling member, the first gear, and the second gear to move the movable element.

CLAIM OF PRIORITY

This application is a continuation of and claims the benefit of priorityunder 35 U.S.C. § 120 to U.S. patent application Ser. No. 15/927,926,filed on Mar. 21, 2018, which claims the benefit of priority under 35U.S.C. § 119(e) to U.S. Provisional Patent Application Ser. No.62/474,360, filed on Mar. 21, 2017, each of which is incorporated byreference herein in its entirety.

BACKGROUND

Medical device systems can include components that are driven by drivemechanisms such as electric motors. Drive components such as gears,levers, and tubes can be used to translate movement through a drivesystem to a medical tool. For example, surgical systems can includetools that are controlled and driven by mechanical drive systems.Surgical systems can include tools such as cutters, staplers, andcautery tools. These types of tools can be used, for example, inminimally invasive surgical procedures.

In some procedures, an endoscope is inserted into the patient's body toprovide a view of internal organs or other features inside a patient. Aprocedure that involves introduction of an endoscope is called anendoscopy. A common form of endoscopy, called laparoscopy, involvesinsertion of an endoscope through the abdominal wall of a patient.Endoscopic and laparoscopic procedures can involve drive systems thatcontrol surgical instruments inside the patient.

SUMMARY

This document discusses, among other things, systems and methods tomanually operate a medical device drive system. It can be useful tomanually operate a medical device drive system when a surgical elementsuch as an instrument cannot be retracted using a telerobotic system dueto a power failure or some other event during a surgical procedure.

An example (e.g., “Example 1”) of subject matter (e.g., a system) mayinclude a rotational input, a coupling member engaged with therotational input, a first gear having an engagement feature sized andshaped to engage with the coupling member, and a second gear coupledwith the first gear, the second gear coupled to a movable element. Anexample system may have a first system state and a second system state,where in the first system state the coupling member is not engaged withthe engagement feature and the first gear rotates without moving thecoupling member, and in the second system state the coupling member isengaged with the engagement feature of the first gear and rotation ofthe rotational input turns the coupling member, the first gear, and thesecond gear to move the movable element.

In Example 2, the medical device drive system of Example 1 mayoptionally be configured such that the coupling member is slidablycoupled to the rotational input, and the coupling member slides awayfrom the rotational input as the rotational input is turned in a firstdirection.

In Example 3, the medical device drive system of Example 1 or 2 mayoptionally be configured such that the first gear includes a protrusionincluding a first set of teeth and the coupling member includes a secondset of teeth. The first set of teeth may be sized and shaped to engagethe second set of teeth when the coupling member is advanced toward thefirst gear.

In Example 4, the medical device drive system of Example 3 mayoptionally be configured such that the first set of teeth and the secondset of teeth are arranged around a rotational axis. The coupling membermay be slidable along the rotational axis and the coupling member andthe first gear being rotatable around the rotational axis.

In Example 5, the medical device drive system of any one or anycombination of Examples 1-4 may further include a rotational resistancemember that resists rotation of the coupling member. In an example, therotational resistance member may be the ratchet. In another example, therotational resistance member may include a belt, and a belt coupling(e.g., pulley) may be configured to translate distally as the couplingmember moves distally.

In Example 6, the medical device drive system of Example 5 mayoptionally be configured such that in the first system state, a firstmoment exerted by the rotational resistance member on the couplingmember exceeds a second moment exerted by the rotational input on thecoupling member such that turning the rotational input biases thecoupling member away from the rotational input, and in the second systemstate the first moment exerted by the a rotational resistance member onthe coupling member is less than the first exerted by the rotationalinput on the coupling member such that turning the rotational input inthe second state rotates the coupling member. In an example, when aforce is applied to the coupling member, the coupling member initiallymoves distally through an axial range of motion, and then when thecoupling member reaches a most distal position, the coupling memberrotates when a force on the input member creates a moment that is largeenough to overcome a counter-moment from a force exerted by therotational resistance member.

In Example 7, the medical device drive system of Example 6 mayoptionally be configured such that the coupling member includes a rampand the rotational input is sized and shaped to engage the ramp, whereinrotation of the rotational input engages the rotational input againstthe ramp and biases the coupling member away from the rotational inputand toward the first gear. The rotational input may, for example,include a ramp that is sized and shaped to engage with the ramp on thecoupling member. The ramps may, for example, follow a circumferentialpath around a common axis. In an example configuration, the couplinginput may include two or more ramps, and the rotational input may besized and shaped to engage both ramps.

In Example 8, the medical device drive system of claim 6 may optionallybe configured such that the rotational input includes a ramp and thecoupling member is sized and shaped to engage the ramp, wherein rotationof the rotational input engages the ramp against the coupling member andbiases the coupling member away from the rotational input and toward thefirst gear.

In Example 9, the medical device drive system of any one or anycombination of Examples 1-8 may further include a third gear engagedwith the first gear and the second gear, the first gear coupled to thethird gear with the second gear.

In Example 10, the medical device drive system of any one or anycombination of Examples 1-9 may further include a spring between thecoupling member and the first gear, the spring sized and shaped to biasthe coupling member away from the first gear. The system may optionallybe configured such that in a neutral position the coupling member isdisengaged from the first gear.

In Example 11, the medical device drive system of any one or anycombination of Examples 1-10 may further include a manual drive locksized and shaped to engage the coupling member, wherein the manual drivelock prevents the coupling member from disengaging from the first gear.

In Example 12, the medical device drive system of Example 11 mayoptionally be configured such that the medical device drive interfaceswith an adaptor to operatively couple the drive system to a computerizedcontrol system. The adaptor may include a switch engagement portion,such as a latch, that is configured to engage a switch to activate themanual drive lock, such that in a first adaptor state the medical devicedrive system is not interfaced with the adaptor and the and the manualdrive lock is not engaged with the coupling member, and in a secondadaptor state the medical device drive system is engaged with theadaptor and the manual drive lock is biased toward an locking feature onthe coupling member. In an example, when coupling member engages thefirst gear, the manual drive lock engages the locking feature on thecoupling member and locks the coupling member into engagement with thefirst gear.

An Example medical device drive system (“Example 13”) may include afirst gear, a second gear coupled to a drive train that is configured toretract an instrument, the second gear coupled to the first gear, and amanual input that is selectively engageable with the first gear. Thesystem may optionally be configured such that in a first state themanual input is not engaged with the first gear, and actuation of themanual input does not turn the first gear and does not retract theinstrument, and in a second state the manual input is engaged with thefirst gear, and actuation of the manual input turns the first gear andthe second gear to retract the instrument.

In Example 14, the medical device drive system of Example 13 may furtherinclude a coupling member, and may optionally be configured such thatthe manual input is selectively engageable with the first gear with bythe coupling member.

In Example 15, the medical device drive system of Example 14 mayoptionally be configured such that in the first state actuation of themanual input advances the coupling member toward the first gear untilthe coupling member engages the first gear.

In Example 16, the medical device drive system of Example 15 may furtherinclude a manual drive lock, wherein when the manual drive lock isactivated the system is locked in the second state by manual drive lockwhen the system is advanced from the first state to the second state.

In Example 17, the medical device drive system of Example 15 or 16 mayoptionally be configured such that the manual input is biased toward thefirst state by a spring.

In Example 18, the medical device drive system of any one or anycombination of Examples 13-17 may further include a third gear coupledto the first gear and the second gear, the third gear being selectivelyengageable with a telerobotic control system.

An example medical device drive system (“Example 19”) may include ameans for driving a manual input against a coupling member, a means forengaging the coupling member with a first gear; and a means forretracting an instrument. The means for retracting the instrument may becoupled to the first gear. The system may be configured such that in afirst state the coupling member is not engaged with the first gear andactuating the manual input moves the coupling member toward the firstgear but does not drive the first gear, and in a second state thecoupling member is engaged with the first gear and actuating the manualinput drives the first gear and retracts the instrument.

In Example 20, the medical device drive system of Example 19 may furtherinclude a means for locking the coupling member with the first gear.

In Example 21, the medical device drive system of Example 19 or 20 mayoptionally be configured such that the means for engaging the couplingmember with the first gear includes a means for advancing the couplingmember toward the first gear, and the system may further include a meansfor resisting rotation of the coupling member as the coupling memberadvances toward the first gear. In an example, the means for resistingrotation of the coupling member as the coupling member advances towardthe first gear may include a ratchet, or a belt on a sliding beltpulley, or a belt that slides distally with respect to a pulley or belttensioning member, or a belt that slides with respect to the couplingmember.

In Example 22, the medical device drive system of any one or anycombination of Examples 19-21 may further include a telerobotic controlsystem coupled to the means for retracting the instrument. In anexample, the first state the telerobotic control system drives the meansfor retracting an instrument without engaging the first gear, and in thesecond state the manual input drives the first gear and the means forretracting the instrument.

An example method of controlling an instrument (“Example 23”) mayinclude driving a manual input against a coupling member to advance thecoupling member into engagement with a first gear, driving the firstgear with the coupling member and manual input, and driving a drivetrain with the first gear to retract a moveable element.

In Example 24, the method of Example 23 may further include locking thecoupling member in an engaged position with a manual lock switch thatengages the coupling member.

In Example 25, the method of Example 23 or 24 may further includedriving the drive train with a telerobotic control system to retract themovable element when the coupling member is not engaged with the firstgear.

In Example 26, the method of any one or any combination of Examples23-25 may further include biasing the coupling member out of engagementwith the first gear when the manual input is released.

An example (e.g., “Example 27”) of subject matter (e.g., a system orapparatus) may optionally combine any portion or combination of anyportion of any one or more of Examples 1-26 to include “means for”performing any portion of any one or more of the functions or methods ofExamples 1-26, or a “machine-readable medium” (e.g., massed,non-transitory, etc.) including instructions that, when performed by amachine, cause the machine to perform any portion of any one or more ofthe functions or methods of Examples 1-26.

Each of these non-limiting examples can stand on its own, or can becombined in various permutations or combinations with one or more of theother examples.

This Summary is intended to provide an overview of subject matter of thepresent patent application. It is not intended to provide an exclusiveor exhaustive explanation of the invention. The detailed description isincluded to provide further information about the present patentapplication.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, which are not necessarily drawn to scale, like numeralsmay describe similar components in different views. Like numerals havingdifferent letter suffixes may represent different instances of similarcomponents. The drawings illustrate generally, by way of example, butnot by way of limitation, various embodiments discussed in the presentdocument.

FIG. 1A is an illustration of an example instrument system for use inrobot-assisted minimally invasive surgery.

FIG. 1B is an illustration of an example physician console for use inrobot-assisted minimally invasive surgery.

FIG. 1C is an illustration of an example control cart for use inrobot-assisted minimally invasive surgery.

FIG. 1D is a perspective view of an example medical device drive systemconnected to an example medical tool.

FIG. 2 is a perspective view of a proximal end of a drive system.

FIG. 3A is a side view of drive components in a proximal end of a drivesystem.

FIG. 3B is a perspective view of drive components in a proximal end of adrive system.

FIG. 4 is a perspective view of a bottom side of a manual input.

FIG. 5 is a top perspective view of components in the proximal end ofthe drive system, with the manual input removed.

FIG. 6 is a perspective bottom view of a coupling component.

FIG. 7 is a perspective view of a first gear.

FIG. 8A is a cross-sectional view of drive components in the proximalend of the drive system, with the coupling member not engaged with thefirst gear.

FIG. 8B is a cross-sectional view of drive components in the proximalend of the drive system, with the coupling member engaged with the firstgear.

FIG. 8C is a cross-sectional view of drive components in the proximalend of the drive system, with springs biasing the coupling member awayfrom the first gear.

FIG. 9 is a perspective view of portions of the proximal end of thedrive system that shows a lock switch and a lower chassis.

FIG. 10 is a side perspective view that shows drive components, themanual drive lock 910, and the locking feature on the coupling member.

FIG. 11 is a cross-sectional view of drive components, an upper portionof the lock switch, and a portion of the manual drive lock engaged withthe lock switch.

FIG. 12A is a side view of the lower portion of the lock switch, thelower chassis.

FIG. 12B is a side view of the lower portion of the lock switch, with anadapter coupled to the lower chassis.

FIG. 13A is a perspective view showing the manual drive lock disengagedfrom the coupling member.

FIG. 13B is a perspective view showing the manual drive lock engagedwith the coupling member.

FIG. 14A is a perspective view showing the manual drive lock disengagedfrom the coupling member.

FIG. 14B is a perspective view showing the manual drive lock engagedwith the coupling member.

FIG. 15 is a flowchart illustrating an example method of controlling asurgical instrument.

DETAILED DESCRIPTION

Medical device drive systems can be used to control an instrument thatis coupled to a drive system with a shaft. A teleoperated surgicalsystem, for example, can employ a medical device drive system to controla surgical instrument that can be inserted into a patient to perform asurgical procedure.

Manipulation of a surgical instrument during a teleoperated surgicalprocedure can be difficult, due to factors such as space constraints,the size of components, the need for precision and accuracy duringsurgery, and the presence of multiple tools in the body.

The present inventors have recognized, among other things, that a manualinput system for a medical device drive train can be formed with acoupling member that can be engaged and disengaged with a drive train. Asystem can enable, for example, manual retraction of a device drivetrain in the event of a power outage, system fault, torque limittrigger, jam, or other event during a procedure. In some examples,manual retraction can be controlled with a manual input, such as a knob.The system can be configured so that the manual input (e.g., knob) doesnot turn when the drive system is being driven by the system. The systemcan also be configured so that a manual input can only retract the drivesystem, and not advance it. In some examples, the system can beconfigured so that the manual input cannot apply enough torque to themanual input to damage the drive train. The system can also beconfigured so that the manual input can apply high forces in theretraction direction to the drive train to enable retraction during aprocedure.

An example medical device drive system can include a rotational inputand a coupling member engaged with the rotational input. The rotationalinput can be a manual input. The system can also include a first gearhaving an engagement feature sized and shaped to engage with thecoupling member, and a second gear coupled with the first gear. Thesecond gear coupled to a movable element, such as a surgical instrument.The system may have a first system state, in which the coupling memberis not engaged with the engagement feature and the first gear rotateswithout moving the coupling member. This may enable, for example, adrive train to be driven by a computer-controlled system, withoutrotation of the rotational input when the gears are driven. The systemmay also have a second system state, in which the coupling member isengaged with the engagement feature of the first gear and rotation ofthe rotational input turns the coupling member, the first gear, and thesecond gear to move the instrument. The system may include one or moreadditional gears between the first and second gear, or coupled to thefirst or second gear to enable connection to other aspects of thesystem, such as elements of a robot-assisted minimally invasive surgicalsystem.

FIGS. 1A, 1B, and 1C illustrate an example robot-assisted minimallyinvasive surgical system. FIG. 1A shows an instrument system 100(sometimes known as a “patient side cart”) that can be situated near apatient operating table (not shown). FIG. 1B shows a surgeon console 150that can include controls and a viewing system. FIG. 1C shows a controlcart 175 that can include, for example, processing equipment andcommunication equipment.

Referring again to FIG. 1A, the system 100 can include a base 102, asupport tower 104, and one or more manipulator arms 110, 111, 112, 113,which can be mounted on the support tower. Alternatively, themanipulator arms 110, 111, 112, 113 can be connected to a main boom (notshown), which can be movable. An instrument 130 can be mounted to aninstrument mount 120 on one of the manipulator arms. A cannula (notshown in FIG. 1A) can be mounted to a cannula mount. An instrument 130can be inserted through a cannula seal in the cannula, and into thepatient (not shown) for use in a surgical or other medical procedure.Through movement of the manipulator arms, the orientation of theinstrument can be controlled in multiple dimensions, e.g. lateral,horizontal, vertical, angular movements in one, two, or three planes.

FIG. 1B shows an example physician console 150. The physician consolecan include hand control 155, 156 and pedal controls 160, 161. The handcontrols 155, 156, and pedal controls 160, 161 can be used to controlequipment at the patient side cart. For example, portions of a distalend of an instrument can be manipulated using instrument controls. Thecontrols can include haptic feedback features so that a physician caninterpret physical information, such as resistance or vibration, throughthe controls. The physician console 150 can also include a viewingsystem 165 that can display video or other images of a surgical site.

FIG. 1C shows an example control cart 175. The control cart can includeprocessing equipment 180 for processing controls, facilitatingcommunication between the physician console and the patient side cart,or a remote site. The control cart 175 can also include a display 190,which can show images that the physician is seeing on the physicianconsole, a video feed from a camera in the patient, or otherinformation. In an example configuration, signals input at a surgeonconsole 150 can be transmitted to the equipment 180 on the control cart,which can interpret the inputs and generate commands that aretransmitted to the patient side cart 100 to cause manipulation of aninstrument 130 or portions of a manipulator arm 110. The equipment 180is shown on a cart for exemplary purposes, but could also be arranged invarious configurations, e.g., it could be integrated as part of thephysician console, the patient side cart, or both, or divided betweenthe physician console and patient side cart. The equipment can also beprovided as software, hardware, or both, on an installed or remotesystem.

FIG. 1D shows an example medical device system 101 that can be mountedon and used with the instrument system 100 shown in FIG. 1A. The medicaldevice system 101 can include a proximal portion 105 including aninterface 185 that can couple to a computerized control system such asthe system illustrated in FIGS. 1A, 1B, and 1C, a middle portion 186that can include drive components such as a drive member (not shown inFIG. 1D), and a distal portion 187 that can include a surgical tool 188.The middle portion 186 can include portions of a drive train 189 thatcan couple the proximal portion 105 to a moveable element 191 that canbe coupled to the surgical tool 188. The surgical tool 188 can, forexample, be any of a variety of surgical tools, such as a cutter,grasper, a cautery tool, a camera, a light, or a surgical stapler. Thesurgical tool 188 can be the instrument 130 shown in FIG. 1A. For thepurpose of this document, the terms “tool” and “instrument” areinterchangeable.

FIG. 2 is a perspective view of a proximal end of a drive system. Thedrive system 200 can be mounted on a chassis 205. The drive system 200can include a manual input 210 that may be a rotational input such as aknob. The manual input 210 can engage other components (not shown inFIG. 2 ) to drive a moveable element and actuate an instrument or tool,such as a surgical stapler or cuter.

FIGS. 3A and 3B are a side and perspective views of drive components ina proximal end 300 of a drive system. The manual input 210 can beengaged with a coupling member 510 (better shown in subsequent figures)that can engage with a first gear 305 that can be coupled with a secondgear 310 that can be engaged with a moveable component to move oractuate an instrument or tool. In some examples, the first gear 305 canbe coupled to the second gear 310 with a third gear 315, which canoptionally be coupled to computerized control system, which can be partof a robot-assisted surgical system.

FIG. 4 is a perspective view of a bottom side of the manual input 210.FIG. 5 is a top perspective view of components in the proximal end ofthe drive system, with the manual input removed. The manual input 210(shown in FIG. 4 ) can be configured to engage with a coupling member510 (shown in FIG. 5 .) In an example, the coupling member can include afirst engagement feature 515, which can for example include a recessionin a top surface 525 of the coupling member, and the manual input 210can include a second engagement feature 415, which can be a protrusion,that is sized and shaped to engage with the first engagement feature515. The second engagement feature 415 can be located in a recession 405in a bottom surface 410 of the manual input 210. While the firstengagement feature 515 is shown as a recession and the second engagementfeature 415 is shown as a protrusion, the parts can also be reversed,such that the manual input includes a protrusion and the coupling member510 includes a recession, or both parts may include a protrusion.

The first engagement feature 515 can be shaped to extend around acircumferential path around a coupling member axis 520, and the secondengagement feature 415 can be shaped to extend along a circumferentialpath around a manual input axis 425. The manual input 210 and couplingmember 510 can be sized and shaped to align the manual input axis 420with the coupling member axis 525. The alignment of the axes 425, 525and the shaping of the engagement features can allow the manual input210 to rotate with respect to the coupling member 510 around the alignedaxes. In various examples, the first engagement feature 515 can includea ramp 530, the second engagement feature 415 can include a ramp 430, orboth the first engagement feature 515 and the second engagement feature415 can include a ramp. The presence of the ramp shape can cause thecoupling member 510 to move distally with respect to the manual input210 when the manual input is rotated in a first direction (indicated byarrow) with respect to the coupling member 510 in a rotational directionthat presses the engagement features 415, 515 together. Turning themanual input 210 in a second direction may allow the coupling member tomove proximally.

The manual input 210 and coupling member 510 can each optionally includemore than one engagement feature. In the illustrated example, the manualinput 210 includes a second manual input engagement feature 416, and thecoupling member 510 includes second coupling member engagement feature516. The manual input engagement feature 416 is shown as a protrudingramp, but could alternatively be a recession, i.e. the manual input 210can include one protruding ramp and one recession, and the couplingmember 510 can include one corresponding recession and one ramp thatalign with the features on the manual input 210. In other examples, themanual input 210 and coupling member 510 can each include three, four,or more engagement features that are sized and shaped to engage witheach other and bias the coupling member 510 in the distal direction whenthe manual input is rotated.

FIG. 6 is a perspective view of the bottom side 605 of the couplingmember 510. The coupling member can include teeth 610 on an outersurface 615 that can be configured to engage with a ratchet 550 (shownin FIG. 5 ). The ratchet can include one or more ratchet arms 555, 556,that can engage with the coupling member teeth 610. The ratchet arms555, 556, can provide a force that resists rotation of the couplingmember 510 in the first direction (indicated by the arrow in FIG. 5 ).The ratchet arms 555, 556 can also be sized and shaped to preventrotation of the coupling member 510 in a second direction opposition thefirst direction.

Referring again to FIG. 6 , the coupling member 510 can include one ormore engagement features 620 (shown in FIG. 6 ) that are sized andshaped to engage with the engagement features 720 on the first gear(shown in FIG. 7 .) The coupling member 510 can also include a bore 630that can receive a shaft.

FIG. 7 is a perspective view of first gear 700. The first gear caninclude a lower portion 705 that includes gear teeth 710 and an upperportion 715 that can include one or more engagement features 720. Theengagement features 720 can be on a tapered portion 725 on a top(proximal) side 730 of the first gear 700. The engagement features 720may, for example, be teeth. The tapered surface can be frustum-shaped(as shown), rounded, hemispherical, or otherwise configured to move inand out of engagement with the coupling member. While the first gear isdepicted as a gear, in other types of drive systems, the first gear 700can alternatively be configured differently. For example, in abelt-driven system, the first gear 700 can be a pulley and the gearteeth 710 can be a belt engagement surface.

FIG. 8A is a cross-sectional view of drive components 800 in theproximal end of the drive system 200, with the coupling member 510 notengaged with the first gear 700. The manual input 210 can be assembledonto the coupling member 510, which can be assembled above the firstgear 700. The manual input can be rotated counter-clockwise (asindicated by the arrow 805), which rotates engagement features 415, 416on the underside of the manual input 210 against engagement features515, 516 on the top side of the coupling member, and biases the couplingmember 510 in a distal direction (as indicated by the arrow 810). Movingthe coupling member 510 distally can engage the coupling member 510 withthe first gear 700. The coupling member can thus operate as aninterlock, i.e. the coupling member can selectively couple and uncouplethe manual input 210 with the first gear 700. In some examples, springs815, 816 can be assembled between the manual coupling member 510 and thefirst gear 700 to bias the coupling member to an uncoupled position inwhich the coupling member 510 is not engaged with the spring. The manualinput 210, coupling member 510, and first gear 700 can be assembled ontoa shaft (not shown) that can extend through bores 450, 630, 750 in eachof the assembled components and maintain axial alignment of thecomponents.

FIG. 8B is a cross-sectional view of drive components in the proximalend of the drive system 200, with the coupling member 510 engaged withthe first gear 700. Rotation of the manual input 210 to advance thecoupling member distally eventually produces the configuration shown inFIG. 8B, where the springs 815, 816 are compressed and the engagementfeatures 620 on the distal side of the coupling member 510 are engagedwith the engagement features 720 (e.g., tapered teeth) on the proximalside of the first gear 700. Rotation of the manual input 210counter-clockwise (as indicated by arrow 840) rotates the couplingmember 510, which rotates the first gear 700 (as indicated by arrow850).

To retract a moveable element, a user can rotate the manual input 210 toadvance the coupling member 510, compress the springs 815, 816 andengage the coupling member 510 with the gear 700 to engage a drive trainthat may retracts the moveable element, which may, for example, be asurgical instrument, or coupled to a surgical instrument.

FIG. 8C is a cross-sectional view of drive components in the proximalend of the drive system 200, with springs 815, 816 biasing the couplingmember away from the first gear. When the manual input 210 is released,the springs 815, 816 exert an upward (proximal) force (indicated byarrow 860 on the coupling member 510, which drives the coupling membertoward the manual input 210 and out of engagement with the first gear.In some examples, the springs also turn the manual input 210 in aclockwise direction (as indicated by arrow 865), for example as ramps onthe coupling member 510 slide against ramps on the manual input 210. InFIG. 8C, the coupling member has slid to a most proximal position, andthe coupling member 510 is disengaged from the first gear 700.

FIGS. 9 through 14B illustrate the operation of a manual drive lock 910that may engage the coupling member 510. The manual drive lock 910 mayinclude a locking element 920 that can move into and out of engagementwith a locking feature 560 (such as a notch or groove) on the couplingmember 510 that prevents the coupling member 560 from moving in aproximal direction when the manual input 210 is released.

FIG. 9 is a perspective view of portions of the proximal end of thedrive system that shows a lock switch 905 and a lower chassis 205. Thelock switch 905 can be coupled to the manual drive lock 910. The lockswitch 905 may, for example include a linkage 915 that couples a lowerportion of the lock switch 907 with an upper portion of the lock switch(shown in FIG. 11 ). In another configuration, the lower portion 907 ofthe lock switch 905 may be directly connected to the upper portion 906of the lock switch.

FIG. 10 is a side perspective view that shows drive components, themanual drive lock 910, and the locking feature 560 on the couplingmember 510.

FIG. 11 is a cross-sectional view of drive components, an upper portion906 of the lock switch 905, and a portion of the manual drive lock 910engaged with the lock switch. The upper portion 906 of the lock switch905 can include a ramp 916 that engages with a ramp 911 on the manualdrive lock 910. The manual drive lock can be biased with a spring 1405(shown in FIG. 14B) to rotate toward the locking feature 560 on thecoupling member 510. The ramp 916 on the upper portion 906 of the lockswitch prevents the manual drive lock 910 from rotating into engagementwith the coupling member. A spring 925 can be coupled to the upperportion 906 of the lock switch 905 and configured to bias the lockswitch down so that the ramp 916 on the lock switch remains inengagement with the ramp on the manual drive lock 910.

FIG. 12A is a side view of the lower portion 907 of the lock switch, thelower chassis 205. The lower portion 907 of the lock switch can includea lever 930. When the lever 930 is in a down position (as indicated byarrow 931), the upper portion 906 of the lock switch (shown in FIG. 11 )retains the manual drive lock 910 in a disengaged position, as shown inFIG. 13A and FIG. 14A.

FIG. 12B is a side view of the lower portion 907 of the lock switch,with an adapter 1200 coupled to the lower chassis 205. When the lever930 is biased to an upward position (as indicated by arrow 1205), thelock switch 910 moves upward, and the upper portion 906 of the lockswitch slides out of engagement with the manual drive lock 905, allowingthe manual drive lock to rotate into engagement with the engagementfeature (e.g. groove) 560 on the coupling member 510, as shown in FIG.13B and FIG. 14B.

In an example, a latch 1210 on the adaptor 1200 may actuate the lever930 to the upward position and thereby disengage the lock switch. Withthe lock switch 910 disengaged, the manual drive lock 905 may be free torotate into engagement with the engagement feature 560 on the couplingmember 510. In some example, the engagement feature 560 is sized andshaped so that the manual drive lock 905 can engage the coupling memberonly when the coupling member is in a lower (distal) position, in whichthe coupling member 510 is engaged with the first gear 700. In anexample workflow, in a state in which the lock switch is biased upward,such as when the adaptor 1200 is coupled to the chassis 205 and thelatch 1205 is engaged with the lever 930, when the manual input 210 isactuated to advance the coupling member 510 distally and engages thefirst gear 700, the manual drive lock rotates into engagement with theengagement feature (groove) 560 on the coupling member, which can lockthe manual drive components in position and allow for manual retractionby rotation of the manual 210, without re-engaging the coupling memberif the manual input is released.

FIG. 15 is a flowchart illustrating an example method 1500 ofcontrolling a surgical instrument. At step 1505, a manual input such asmanual input 210 is driven against a coupling member, such as couplingmember 510. At step 1510, the coupling member is advanced intoengagement with a first gear, such as gear 700. At step 1515, thecoupling member is optionally locked into an engaged position, forexample with a manual lock that engages the coupling member. At step1520, the first gear is driven by the coupling member and the manualinput by rotating the manual input, to retract a moveable element, whichmay for example be coupled to a surgical instrument inside a patientduring a surgical procedure. The drive train may also optionally bedriven by a computer-controlled system, with the manual drive input usedfor example during a power failure or system fault. At step 1525, thecoupling member is biased out of engagement with the first gear when themanual input is released and the manual drive lock is in an unengagedposition.

Each of these non-limiting examples can stand on its own, or can becombined in various permutations or combinations with one or more of theother examples.

The above detailed description includes references to the accompanyingdrawings, which form a part of the detailed description. The drawingsshow, by way of illustration, specific embodiments in which theinvention can be practiced. These embodiments are also referred toherein as “examples.” Such examples can include elements in addition tothose shown or described. However, the present inventors alsocontemplate examples in which only those elements shown or described areprovided. Moreover, the present inventors also contemplate examplesusing any combination or permutation of those elements shown ordescribed (or one or more aspects thereof), either with respect to aparticular example (or one or more aspects thereof), or with respect toother examples (or one or more aspects thereof) shown or describedherein.

In the event of inconsistent usages between this document and anydocuments so incorporated by reference, the usage in this documentcontrols.

In this document, the terms “a” or “an” are used, as is common in patentdocuments, to include one or more than one, independent of any otherinstances or usages of “at least one” or “one or more.” In thisdocument, the term “or” is used to refer to a nonexclusive or, such that“A or B” includes “A but not B,” “B but not A,” and “A and B,” unlessotherwise indicated. In this document, the terms “including” and “inwhich” are used as the plain-English equivalents of the respective terms“comprising” and “wherein.” Also, in the following claims, the terms“including” and “comprising” are open-ended, that is, a system, device,article, composition, formulation, or process that includes elements inaddition to those listed after such a term in a claim are still deemedto fall within the scope of that claim. Moreover, in the followingclaims, the terms “first,” “second,” and “third,” etc. are used merelyas labels, and are not intended to impose numerical requirements ontheir objects.

Geometric terms, such as “parallel”, “perpendicular”, “round”, or“square”, are not intended to require absolute mathematical precision,unless the context indicates otherwise. Instead, such geometric termsallow for variations due to manufacturing or equivalent functions. Forexample, if an element is described as “round” or “generally round”, acomponent that is not precisely circular (e.g., one that is slightlyoblong or is a many-sided polygon) is still encompassed by thisdescription.

Method examples described herein can be machine or computer-implementedat least in part. Some examples can include a computer-readable mediumor machine-readable medium encoded with instructions operable toconfigure an electronic device to perform methods as described in theabove examples. An implementation of such methods can include code, suchas microcode, assembly language code, a higher-level language code, orthe like. Such code can include computer readable instructions forperforming various methods. The code may form portions of computerprogram products. Further, in an example, the code can be tangiblystored on one or more volatile, non-transitory, or non-volatile tangiblecomputer-readable media, such as during execution or at other times.Examples of these tangible computer-readable media can include, but arenot limited to, hard disks, removable magnetic disks, removable opticaldisks (e.g., compact disks and digital video disks), magnetic cassettes,memory cards or sticks, random access memories (RAMs), read onlymemories (ROMs), and the like.

The above description is intended to be illustrative, and notrestrictive. For example, the above-described examples (or one or moreaspects thereof) may be used in combination with each other. Otherembodiments can be used, such as by one of ordinary skill in the artupon reviewing the above description. The Abstract is provided to complywith 37 C.F.R. § 1.72(b), to allow the reader to quickly ascertain thenature of the technical disclosure. It is submitted with theunderstanding that it will not be used to interpret or limit the scopeor meaning of the claims. Also, in the above Detailed Description,various features may be grouped together to streamline the disclosure.This should not be interpreted as intending that an unclaimed disclosedfeature is essential to any claim. Rather, inventive subject matter maylie in less than all features of a particular disclosed embodiment.Thus, the following claims are hereby incorporated into the DetailedDescription as examples or embodiments, with each claim standing on itsown as a separate embodiment, and it is contemplated that suchembodiments can be combined with each other in various combinations orpermutations. The scope of the invention should be determined withreference to the appended claims, along with the full scope ofequivalents to which such claims are entitled.

The claimed invention is:
 1. A medical device drive system comprising: arotational input; a coupling member engaged with the rotational input; afirst gear having an engagement feature sized and shaped to engage withthe coupling member; and a second gear coupled with the first gear, thesecond gear being coupled to a movable element, wherein; the rotationalinput is configured to rotate in a first direction to cause the couplingmember to engage with the engagement feature of the first gear and torotate the coupling member, the first gear, and the second gear to movethe movable element; and the rotational input is configured to rotate ina second direction without causing the coupling member to be engagedwith the engagement feature and without moving the movable element. 2.The medical device drive system of claim 1, wherein the coupling memberis slidably coupled to the rotational input, the coupling member slidingaway from the rotational input as the rotational input is turned in thefirst direction.
 3. The medical device drive system of claim 1, whereinthe first gear includes a protrusion including a first set of teeth andthe coupling member includes a second set of teeth, the first set ofteeth sized and shaped to engage the second set of when the couplingmember is advanced toward the first gear.
 4. The medical device drivesystem of claim 3, wherein the first set of teeth and the second set ofteeth are arranged around a rotational axis, the coupling member beingslidable along the rotational axis and the coupling member and the firstgear being rotatable around the rotational axis.
 5. The medical devicedrive system of claim 1, further comprising a rotational resistancemember that resists rotation of the coupling member.
 6. The medicaldevice drive system of claim 5, wherein a first moment exerted byrotation of the rotational input in the first direction on the couplingmember is greater than a second moment exerted by the rotationalresistance member on the coupling member such that rotating therotational input in the first direction rotates the coupling member. 7.The medical device drive system of claim 6, wherein the coupling memberincludes a ramp and the rotational input is sized and shaped to engagethe ramp, wherein rotation of the rotational input in the firstdirection engages the rotational input against the ramp and biases thecoupling member away from the rotational input and toward the firstgear.
 8. The medical device drive system of claim 6, wherein therotational input includes a ramp and the coupling member is sized andshaped to engage the ramp, wherein rotation of the rotational input inthe first direction engages the ramp against the coupling member andbiases the coupling member away from the rotational input and toward thefirst gear.
 9. The medical device drive system of claim 1, furthercomprising a third gear engaged with the first gear and the second gear,the first gear coupled to the third gear with the second gear.
 10. Themedical device drive system of claim 1, further comprising a springbetween the coupling member and the first gear, the spring sized andshaped to bias the coupling member away from the first gear, wherein ina neutral position the coupling member is disengaged from the firstgear.
 11. The medical device drive system of claim 1, further comprisinga manual drive lock sized and shaped to engage the coupling member,wherein the manual drive lock prevents the coupling member fromdisengaging from the first gear.
 12. The medical device drive system ofclaim 11, wherein the medical device drive system is configured tointerface with an adaptor to operatively couple the drive system to acomputerized control system, the adaptor including a switch engagementportion configured to engage a switch to activate the manual drive lock,wherein in a first adaptor state the medical device drive system is notinterfaced with the adaptor and the and the manual drive lock is notengaged with the coupling member, and in a second adaptor state themedical device drive system is engaged with the adaptor and the manualdrive lock is biased toward an locking feature on the coupling member,wherein when coupling member engages the first gear the manual drivelock engages the locking feature on the coupling member and locks thecoupling member into engagement with the first gear.
 13. A medicaldevice drive system comprising: a first gear; a second gear coupled to adrive train that is configured to retract an instrument, the second gearcoupled to the first gear; a manual input that is selectively engageablewith the first gear, wherein the manual input is configured to rotate inonly one direction to cause the manual input to engage with the firstgear to rotate the first gear and the second gear to retract theinstrument.
 14. The medical device drive system of claim 13, furthercomprising a coupling member, wherein the manual input is selectivelyengageable with the first gear by the coupling member.
 15. The medicaldevice drive system of claim 14, wherein rotation of the manual input inthe only one direction advances the coupling member toward the firstgear until the coupling member engages the first gear.
 16. The medicaldevice drive system of claim 15, further comprising a manual drive lock,wherein when the manual drive lock is activated the coupling member islocked into engagement with the first gear.
 17. The medical device drivesystem of claim 13, further comprising a third gear coupled to the firstgear and the second gear, the third gear being selectively engageablewith a telerobotic control system.